Zhao Qian, Chen Xia, Li Jing, Jiang Ji, Li Mengtao, Zhong Wen, Li Zhengdong, Leung Shui-On, Zhang Fengchun, Hu Pei
Clinical Pharmacology Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 41 Damucang, Xicheng District, Beijing, 100032, China.
Department of Rheumatology, Peking Union Medical College Hospital, 1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China.
Clin Drug Investig. 2016 Nov;36(11):889-902. doi: 10.1007/s40261-016-0426-7.
SM03 is a novel recombinant, human/mouse chimeric immunoglobulin G1 monoclonal antibody directed against the CD22 antigen on human B lymphocytes. This was the first study to investigate the pharmacokinetics, pharmacodynamics, immunogenicity, safety and clinical activity of SM03 in patients with systemic lupus erythematosus (SLE).
This study was an open, multiple-centre, parallel-group, multiple-ascending-dose, phase I study in 29 SLE patients. Pharmacokinetic assessment was conducted in 22 of these patients. Eligible patients received multiple intravenous infusions of SM03 for 4 weeks (240 mg/m, 600 or 900 mg, once weekly) and were monitored over an 84-day observation period for pharmacokinetics, pharmacodynamics, immunogenicity, safety and clinical response.
After multiple-dose SM03, the maximal serum concentration of SM03 was reached within 3-7 h. The mean elimination half-life was 15 days. The average accumulation ratios of the area under the time-concentration curve and the maximum concentration after the fourth administration of SM03 were 2.0 and 1.5. CD19 B-lymphocyte counts were decreased. Infections were the most common adverse events. No drug-related serious adverse events were reported. The therapeutic benefit of SM03 was observed mainly in patients with moderate-to-severe disease activity.
Pharmacokinetic exposure increased in a lower-than-dose-proportional manner up to 900 mg. SM03 was well tolerated at doses ranging from 240 mg/m to 900 mg, with no new safety signals identified. SM03 has potential efficacy in Chinese patients with SLE.
SM03是一种新型重组人/鼠嵌合免疫球蛋白G1单克隆抗体,可靶向人B淋巴细胞上的CD22抗原。这是第一项研究SM03在系统性红斑狼疮(SLE)患者中的药代动力学、药效学、免疫原性、安全性及临床活性的研究。
本研究为一项开放性、多中心、平行组、多剂量递增的I期研究,纳入29例SLE患者。其中22例患者进行了药代动力学评估。符合条件的患者接受4周的SM03多次静脉输注(240mg/m²、600mg或900mg,每周一次),并在84天的观察期内监测药代动力学、药效学、免疫原性、安全性及临床反应。
多次给予SM03后,3-7小时内达到SM03的最大血清浓度。平均消除半衰期为15天。SM03第四次给药后,时间-浓度曲线下面积和最大浓度的平均蓄积率分别为2.0和1.5。CD19+B淋巴细胞计数下降。感染是最常见的不良事件。未报告与药物相关的严重不良事件。主要在中重度疾病活动的患者中观察到SM03的治疗益处。
高达900mg时,药代动力学暴露以低于剂量比例的方式增加。SM03在240mg/m²至900mg的剂量范围内耐受性良好,未发现新的安全信号。SM03对中国SLE患者具有潜在疗效。